Code Black: What Does It Mean?

Feb. 7, 2006

For the millions of viewers watching promotions during Sunday's Super Bowl, as well as for the millions who tuned in to ABC's medical drama "Grey's Anatomy" after the game, the term "code black" has new meaning.

The staff at fictional Seattle Grace Hospital was seen in crisis mode as it dealt with an emergency -- and then came the ominous instructions: "Tell the charge nurse that we have a code black."

On "Grey's Anatomy" that meant a bomb scare. But what would happen at an actual hospital if a bomb were discovered?

Medical professionals across the country told ABC News that their facilities have codes for bomb threats, but they come in an array of colors -- and in the Midwest, code black often refers to a storm. And some don't have a code for explosives.

"Our code black is for severe weather," said Lisa Jones, spokeswoman for La Rabida Children's Hospital in Chicago. "We do not have a bomb scare code."

At Chilton Memorial Hospital in Pompton Plains, N.J., a bomb threat would be a code yellow, which is what's recommended by the New Jersey Healthcare Emergency Codes, said spokeswoman Sally Malech.

"At our hospital, we do have a code yellow for a suspicious object or a bomb
threat," said Mary Michaels at Avera McKennan Hospital and University Health Center in Aberdeen, S.D. "Our code black here in the Midwest is actually for a tornado.

"There are other codes as well for disasters involving 14 or fewer victims
and 15 or more victims, hazardous materials spill, utility interruption,
fire, missing person (code Adam) and need for evacuation," Michaels said.

Different Terms, Same Alert

At Brigham and Women's Hospital in Boston, the code for a bomb is the opposite. "We don't have a code black at BWH," said spokeswoman Lori Shanks. "We actually use a code white for a bomb threat or suspicious package."

At hospitals affiliated with St. John Health in southeast Michigan, no one would respond to a code black. "In our system, we use code orange for bomb threats," said spokesman Brian Taylor. "I spoke to a few people here and no one has ever heard of a code black."

At UCSD Medical Center in San Diego, a bomb threat would be a code 10. At Rhode Island Hospital/Hasbro Children's Hospital in Providence, R.I., it's a code green. And at the University of Arkansas for Medical Sciences in Little Rock, Ark., it's a code amber.

But at Mount Auburn Hospital in Cambridge, Mass., Cincinnati Children's Hospital Medical Center and the Ohio State University Medical Center, code black would indicate a bomb scare, and at Memorial Healthcare System in Hollywood, Fla., a bomb scare would be a black alert.

John Patrick, an assistant professor of emergency medicine at Harvard Medical School and a doctor at Mount Auburn Hospital, said the codes at many hospitals come from the Hospital Emergency Incident Command system, a widely used template for disaster management supported by the American Hospital Association.